title: Resource-efficient mobilization programs in the intensive care unit: who stands to win?
abstract: BACKGROUND
  Functional outcomes can improve with early intensive care unit (ICU) mobilization programs but require additional resources. Details regarding resource allotment and methods to deliver therapy are lacking. We describe an effective team-based, resource-efficient mobility program (REMP).
  
  
  METHODS
  Consecutive admissions (November 2009 to March 2010) underwent an evaluation by a physical therapist and participation in the REMP. Sitting balance (SB), transfer from bed to chair, and ambulation were assessed on the initial evaluation and compared with ICU and hospital discharge using the Functional Independence Measure scale.
  
  
  RESULTS
  Twenty-eight patients entered the REMP, and 31 patients served as controls. There were no differences in baseline characteristics or initial Functional Independence Measure scores for ambulation or SB. Bed-to-chair evaluation was higher in the controls (P < .024). Both groups improved across the 3 time periods on all measures; however, more REMP patients had a significantly improved SB at ICU and hospital discharge.
  
  
  CONCLUSIONS
  A team-based, resource-efficient approach to early mobilization is feasible and effective in the ICU.
authors.affiliation: Department of Surgery, 80 Seymour Street, Hartford Hospital, Hartford, CT 06102, USA. Electronic address: jwmah@yahoo.com.
authors.forename: John W
authors.initials: JW
authors.lastname: Mah
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.forename: David
authors.initials: D
authors.lastname: Fichandler
authors.forename: Karyn L
authors.initials: KL
authors.lastname: Butler
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016638:Critical Illness / Q000534:rehabilitation*; D004185:Disability Evaluation; D004434:Early Ambulation; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D058996:Quality Improvement
keywords: Ambulation; Critical care; Mobility; Physical therapy; Rehabilitation